Only 9 countries on track to eliminate hepatitis C
New data on hepatitis C released by the Polaris Observatory*, and presented today at the World Hepatitis Summit (WHS) in Sao Paulo, Brazil shows that nine countries — Australia, Brazil, Egypt, Georgia, Germany, Iceland, Japan, the Netherlands and Qatar — are on course to eliminate hepatitis C by 2030.
Worldwide, viral hepatitis kills more than one million people each year, and more than 300 million people are chronically infected with hepatitis B or C. Yet, with the development of highly-effective direct acting antivirals (DAAs) for hepatitis C and the increasing rates of hepatitis B treatment and vaccination coverage globally, elimination of viral hepatitis has become a real possibility.
“This new data shows that elimination of hepatitis C is possible. It also shows more must be done to support governments in tackling viral hepatitis,” said Charles Gore, President of the World Hepatitis Alliance. “The World Hepatitis Summit offers governments the opportunity to learn from other countries and public health experts, in an effort to speed up progress to elimination.”
Since the adoption of World Health Organization’s (WHO) elimination targets in 2016, which include a 90% reduction of new hepatitis B and C infections and a 65% reduction in hepatitis B and C related mortality by 2030, some countries are making great strides yet multiple factors preventing progress remain for the majority. These include a lack of political will and global funding mechanism, poor data and surveillance, access to diagnostics and medicines and poor diagnosis rates (approx. 10% worldwide for hepatitis B and 20% for hepatitis C), that together mean that many countries are struggling to reach the targets.
Some key countries which are being highlighted at the Summit for their innovative work to eliminate viral hepatitis are Brazil, Egypt, Australia and Georgia. In 2017, Egypt pledged to test 30 million for hepatitis C by the end of 2018 by implementing mass screening initiatives (including assistance from the military), as well as mass producing generic copies of DAA drugs for under US $200 per 12-week course.
Meanwhile, WHS host nation Brazil has committed to gradually lift treatment restrictions in 2018, meaning that the country will be able to treat all people infected with hepatitis C, ensuring it is on target to eliminate hepatitis C. Previously, treatment was restricted to only the sickest patients with advanced liver disease.
“Brazil has championed the cause of hepatitis on the world stage for many years and has pushed for an intensified global hepatitis response,” says Adele Schwartz Benzaken, director of the Brazilian Ministry of Health’s Department of Surveillance, Prevention and Control of STIs, HIV/AIDS and Viral Hepatitis. “In addition to the work we have already done on hepatitis B, opening up vaccination to the whole population, we are now gradually removing the restrictions on access to hepatitis C treatment – so that, from 2018 on, the entire infected population can be treated, not just the sickest.”
The Australian government responded to the call for universal access to the hepatitis C DAAs with an AUS $1billion dollar investment over 5 years. This risk-sharing agreement with pharmaceutical companies provides government-funded treatment to all adults without restriction and has paved the way for the elimination of hepatitis C by 2030. More than 30,000 patients with hepatitis C were treated and cured in 2016.
“What we are seeing is that some countries, especially those with a high burden, are making the elimination of viral hepatitis a priority and are looking at innovative ways to do it,” said Homie Razavi, Director of CDA. “However, it will be near-impossible for most other countries to meet the WHO targets without a huge scale-up in political will and access to diagnostics and treatment.”
Although only a handful of countries are on track to reach the WHO’s elimination targets, there are a number of other countries which are making progress. Mongolia, Gambia, and Bangladesh have shown real political will and, along with Brazil, Georgia and Egypt, are spearheading the NOhep Visionary Programme* in their region, due to their commitment to ending their epidemics.
“Because viral hepatitis has been neglected for so long, much needs to be done rapidly to make up for lost time,” concluded Gore. “In that context, the Summit, a biennial event, focuses on the public health approach to viral hepatitis and acts as the central forum for countries to share their experience and best practice in order to drive rapid advances in national responses.”
Hepatitis C vaccine could dramatically reduce transmission in people who inject drugs
MAYWOOD, IL – Among the most serious consequences of the opioid epidemic is the spread of hepatitis C among injecting drug users.
A major new study shows that if a hepatitis C vaccine were successfully developed, it would dramatically reduce transmission of hepatitis C among drug users – even though it’s unlikely such a vaccine would provide complete immunity.
The study, which employed mathematical modeling, is published in Science Translational Medicine.
Four of the study’s authors are members of the Program for Experimental and Theoretical Modeling in the division of hepatology of Loyola Medicine and Loyola University Chicago Stritch School of Medicine. One of the Loyola researchers, Harel Dahari, PhD, is a co-senior author of the study, along with Marian Major, PhD, of the U.S. Food and Drug Administration. Dr. Dahari is an assistant professor at Loyola University Chicago Stritch School of Medicine.
Vaccines are currently available for hepatitis A and hepatitis B, but a vaccine for hepatitis C is still under investigation. A clinical trial is testing an experimental hepatitis C vaccine on injecting drug users. Unlike many other vaccines, the hepatitis C vaccine is not expected to provide complete immunity, known as sterilizing immunity. A vaccinated person exposed to HCV could still be infected with the virus, although the amount of virus in the bloodstream would be significantly reduced.
The new study calculated how effective a vaccine that provided incomplete immunity would be in preventing transmission among injecting drug users. Researchers developed a mathematical model to determine transmission probabilities in drug users who share needles and syringes. They simulated the sharing of two types of common syringes used by drug users. Using previously published data from people infected or reinfected with hepatitis C virus, researchers then estimated the transmission risks between injecting drug users.
The study estimated that if an injecting drug user shared a syringe/needle with a second drug user who was infected with hepatitis C, there would be a greater than 90 percent chance the first drug user would also become infected with hepatitis C after six months. However, if a vaccine were used, the transmission risk would decrease to between 1 and 25 percent, depending on the type of needle used and other factors.
“Our findings suggest that a hepatitis C vaccine would be an essential part of a comprehensive prevention strategy to meet the World Health Organization’s goal of eradicating hepatitis C by 2030,” said study co-author Scott Cotler, MD, head of Loyola’s division of hepatology and a professor in the department of medicine of Loyola University Chicago Stritch School of Medicine. Other Loyola co-authors are mathematical modelers Alexander (Sasha) Gutfraind, PhD, and Louis Shekhtman, MSc.
Hepatitis C is caused by the hepatitis C virus (HCV). Long-term infection with HCV, known as chronic hepatitis C, usually is silent for many years. But the disease eventually can cause cirrhosis (advanced scarring) of the liver, liver cancer and liver failure. In the United States, as many as 3 million people are chronically infected with HCV, with more than 30,000 new infections per year.
Hepatitis C spreads through contaminated blood, and an estimated 60 percent of HCV infections in the U.S. are attributed to sharing needles, syringes or other drug paraphernalia.
Antiviral drugs are used to treat hepatitis C, with cure rates higher than 90 percent. In addition to stopping the disease from progressing, antivirals also can prevent transmission. However, antivirals are expensive, and many injecting drug users lack access to healthcare in the U.S. And even if they are cured, injecting drug users can become infected again if they continue to share needles.
“While extremely effective, antivirals alone are unlikely to eliminate hepatitis C globally,” Dr. Dahari said. “We need to combine antivirals with a hepatitis C vaccine and harm-reduction measures such as needle-syringe exchange programs, opioid substitution therapy and behavioral counseling.”
Some people think a vaccine needs to be perfect, Dr. Dahari added. “But we found that a vaccine still can be extremely beneficial even if it does not provide complete sterilizing immunity.”
The study was conducted with Qingwen Cui, MSc, and Alla Kachko, PhD, of the U.S. Food and Drug Administration, Behzad Hajarizadeh, PhD, of University of New South Wales, Sydney, Australia, Rachel Sacks-Davis, PhD, of the Burnet Institute and University of Melbourne, Kimberly Page, PhD, of the University of New Mexico Health Sciences Center and Basmattee Boodram, PhD, of the University of Illinois at Chicago.
The study is titled, “Modeling of patient virus titers suggests that availability of a hepatitis C vaccine could reduce HCV transmission among injecting drug users.” The study was funded by the Food and Drug Administration, National Institutes of Health, and Burnet Institute.
Alzheimer's and Brain
June is Alzheimer’s and Brain Awareness Month. Alzheimer’s affects more than 3 million Americans in the US. It is a type of dementia that affects memory and overall behavior. The greatest factor is increasing age and it worsens over time. Currently there is no cure to Alzheimer’s but there are treatments available and there is ongoing research to find a cure.
Signs of Alzheimer’s Dementia
Memory loss that disrupts daily life.
Memory loss that disrupts daily life.
Confusion with time/place
Problems with speaking or writing
Misplacing things and losing the ability to retrace steps
Withdrawal from social activities
Changes in mood and personality
Trouble understanding visual images
Source: Alz Org
Join us on June 20th to fight Alzheimer’s via an online or at-home awareness of fundraising activity
More info: The Longest Day